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Home My WebLink About935701 ROCKY MOUNTAIN BANK 2515 FOOTHILL BLVD. ROCK SPRINGS, WYOMING 82901 RECEIVED 12/19/2007 at 3:59 PM RECEIVING # 935701 BOOK: 681 PAGE: 615 - JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 000615 6010716219 Record and Return 0 by Mail 0 by Pickup to: Loan Number: 7319130 MANUFACTURED HOME AFFIDAVIT OF AFFIXATION STATE OF WYOMING COUNTY OF LINCOLN ) ) ss.: ) BEFORE ME. the undersigned notary public. on this day personally appeared DA V I D A. HUNT, JR. known to me to be the person(s) whose name(s) is/are subscribed below (each a "Homeowner"). and who, being by me first duly sworn, did each on his or her oath state as follows: 1. Homeowner owns the manufactured home ("Home") described as follows: USE D New/Used 1998 SKYLINE Year Manufacturer's Name LEXINGTON 2T52-0899K(AB) 66.2 X 26.8 Length x Width Model Name or Model No. Manufacturer's Serial No. ,1 ULI 468828 AND ULI 468829 HUD Label Number(s): Certificate of Title Number: 2. The Home was built in compliance with the federal Manufactured Home Construction and Safety Standards Act. 3. If the Homeowner is the first retail buyer of the Home, Homeowner is in receipt of (i) the manufacturer's warranty for the Home, (ii) the Consumer Manual for the Home, (iii) the Insulation Disclosure for the Home, and (iv) the formaldehyde health notice for the Home. MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 10/20/05 Page 1 of 5 DocMaglc ~ 800-649-1362 www.docmagic.com <\armfbh,wf 4. The Home is or will be located at the following "Property Address": '000616 Slreel or Roule 635 CRATER LANE, ETNA, WYOMING 83118 Cily Counly Slale Zip Code 5. The legal description of the Property Address ("Land") is: SOUTH ONE THIRD OF THE NORTH HALF OF THE NORTHEAST QUARTER OF THE NORTHWEST QUARTER OF SECTION 27, TOWNSHIP 35 NORTH, RANGE 119 WEST, 6TH P.M., LINCOLN COUNTY, WYOMING. A.P.N.: 12-3519-27-2-00-112.00 6. The Homeowner is the owner of the Land or, if not the owner of the Land, is in possession of the real property pursuant to a lease in recordable form, and the consent of the lessor is attached to this Affidavit. 7. The Home 0 is 0 shall be anchored to the Land by attachment to a permanent foundation constructed in accordance with applicable state and local building codes and manufacturer's specifications in a manner sufficient to validate any applicable manufacturer's warranty, and permanently connected to appropriate residential utilities (e.g., water, gas, electricity, sewer) ("Permanently Affixed "). The Homeowner intends that the Home be an immovable fIXture and a permanent improvement to the Land. 8. The Home shall be assessed and taxed as an improvement to the Land. 9. Homeowner agrees that as of today, or if the Home is not yet located at the Property Address, upon the delivery of the Home to the Property Address: (a) All permits required by governmental authorities have been obtained; (b) The foundation system for the Home was designed by an engineer to meet the soil conditions of the Land. All foundations are constructed in accordance with applicable state and local building codes, and manufacturer's specifications in a manner sufficient to validate any applicable manufacturer's warranty. (c) The wheels, axles, towbar or hitch were removed when the Home was, or will be, placed on the Property Address; and (d) The Home is (i) Permanently AffIXed to a foundation, (ii) has the characteristics of site-built housing, and (iii) is part of the Land. 10. If the Homeowner is the owner of the Land, any conveyance or financing of the Home and the Land shall be a single-transaction under applicable state law. 11. Other than those disclosed in this Affidavit, the Homeowner is not aware of (i) any other claim, lien or encumbrance affecting the Home, (ii) any facts or information known to the Homeowner that could reasonably affect the validity of the title of the Home or the existence or non-existence of security interests in it. MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 10/20/05 Page 2 of 5 DoçMaglc~ 800-649-7362 www.docmagic.com '\.rmlbh,wf 12. A Homeowner shall initial only one of the following, as it applies to title to the Home: OOO~1. 7 o The Home is not covered by a certificate of title. The original manufacturer's certificate of origin, duly endorsed to the Homeowner, is attached to this Affidavit, or previously was recorded in the real property records of the jurisdiction where the Home is to be located. o The Home is not covered by a certificate of title. After diligent search and inquiry, the Homeowner is unable to produce the original manufacturer's certificate of origin. o The 0 manufacturer's certificate of origin 0 certificate of title to the Home 0 shall be 0 has been eliminated as required by applicable law. o The Home shall be covered by a certificate of title. 13. The Homeowner designates thefollowing person to record this Affidavit in the real property records of the jurisdiction where the Home is to be located and upon its recording it shall be returned by the recording officer to same: Name: Address: 14. This Affidavit is executed by Homeowner(s) pursuant to applicable state law. IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of the undersigned witnesses on this JLf day of ~~ / .2 007 Witness Witness (Seal) - Borrower (Seal) -Borrower (Seal) -Borrower (Seal) - Borrower (Seal) -Borrower (Seal) -Borrower MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 10/20/05 Page 3 of 5 DocMaglc ~ 800·649-7362 www.docmagic.com ".rmfbh,wC STATE OF WYOMING ) ) ss.: COUNTY OF LINCOLN ) On the J4~ day of ~~) 2007 in the year me, the undersigned. a Notary Public in and for said State. personallyappearedDAVID JR. 00061.8 before A. HUNT, , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument. the individual(s). or the person on behalf of which the individual(s) acted, executed the instrument. County of Lincoln NOTARY PUBLIC State of Wyoming Æ~ Iv. ~-VI."ð Notary Signature (Official Seal) (;'¿O~/17 tV. ßY¿RS Notary Printed Name Notary Public; State of ¿Jy~...9 Qualified in the County of ~ M Commission Expires September 15, 2011 My Commission Expires: 9 - /5 - / J MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 10/20/05 Page 4 of 5 Doc:Maglc: ~ 800-649-1362 www.docmagic.com ".rmfbh,wr Lender's Statement of Intent: '000619 The undersigned ("Lender") intends that the Home be an immovable fixture and a pennanent improvement to the Land. ROCKY MOUNTAIN BANK :-r g~4 Authorized Signatur STATE OF WYOMING ) ) ss.: COUNTY OF LINCOLN ) On the ~ Lf+V' day of ~c.~ in the year (;¿OD f before meJSW)ñ~0ëk~r;;r wd &ate, p=onaUy appeared . personally known to me or proved to me on the b~is-ofsatisfactQry evidence to be the individual(s) wh se name(s) is/are subscribed to the within instrum /t and acknowledged to me that he/she/they e éd the same inhislher/their capacity(ies), and that by his er/their signature(s)on the instrument, the' div,idual(s), or the person on behalf of which the individual(s) a ,xecuted the ~strument. / "" \, '\ ' '..~...........,~, . Notary sf' "- (;;h 11ðY) rn ··'NotarfPrinted Name Notary Public; State of ~ ~ Qualified in the County of t;W.eL~ My Commission Expires: ll{ 'J-ot /1Jf!X)g rš~~Ñ-;~"õ-;È"L~'~~TAR~-';;;;L~é J \" J COUNTY OF STATE OF I " I SWEETWATER OMING i ""ß {1ìt?1 '/W · r iW( Ç'JMMISSION EX:~-iRES ~ t, r¿ð .~ L~_~_~~~____~_~ ~_ ~ (Official Seal) MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 10/20/05 Page 5 of 5 DocMagic ~ 800-649-1362 www.docmBgic.com Aannfbh. we